Mammographic breast density in infertile and parous women

BACKGROUND: Mammographic breast density is a useful marker for breast cancer risk, as breast density is considered one of the strongest breast cancer risk factors. The study objective was to evaluate and compare mammographic breast density in infertile and parous women, as infertility may be associated with high breast density and cancer occurrence. METHODS: This study evaluated mammographic breast density using two different systems, BIRADS and Boyd. A selected patient population of 151 women with primary infertility (case group) was compared to 154 parous women who had at least one previous pregnancy (control group). Both groups were premenopausal women aged ≥ 35. RESULTS: Evaluation of mammographic features showed that 66.9% of case group patients and 53.9% of control group patients were classified BIRADS-3/BIRADS-4; p < 0.05. Adjusted Odds ratio for the case group in the categories BIRADS-3/BIRADS-4 was 1.78 (95% CI: 1.10-2.89). Using the Boyd classification system, 53.6% of case group patients and 31.8% of control group patients were classified E/F; p < 0.05. Adjusted Odds ratio for case group patients in Boyd categories E/F was 2.05 (95 % CI: 1.07-3.93). CONCLUSIONS: Both systems yielded a higher percentage of increased breast density in the case group. Boyd and BIRADS classification systems indicate to what extend breast cancer lesions may be missed on mammography due to masking by dense tissue. Therefore, patients with a high BIRADS or Boyd score should undergo further investigation

Atmospheric deposition of organic matter at a remote site in the central Mediterranean Sea: implications for the marine ecosystem

Abstract. Atmospheric fluxes of dissolved organic matter (DOM) were studied for the first time on the island of Lampedusa, a remote site in the central Mediterranean Sea (Med Sea), between 19 March 2015 and 1 April 2017. The main goals of this study were to quantify total atmospheric deposition of DOM in this area and to evaluate the impact of Saharan dust deposition on DOM dynamics in the surface waters of the Mediterranean Sea. Our data show high variability in DOM deposition rates without a clear seasonality and a dissolved organic carbon (DOC) input from the atmosphere of 120.7 mmol DOC m−2 yr−1. Over the entire time series, the average dissolved organic phosphorus (DOP) and dissolved organic nitrogen (DON) contributions to the total dissolved pools were 40 % and 26 %, respectively. The data on atmospheric elemental ratios also show that each deposition event is characterized by a specific elemental ratio, suggesting a high variability in DOM composition and the presence of multiple sources. This study indicates that the organic substances transported by Saharan dust on Lampedusa mainly come from a natural sea spray and that Saharan dust can be an important carrier of organic substances even though the load of DOC associated with dust is highly variable. Our estimates suggest that atmospheric input has a larger impact on the Med Sea than on the global ocean. Further, DOC fluxes from the atmosphere to the Med Sea can be up to 6 times larger than total river input. Longer time series combined with modeling would greatly improve our understanding of the response of DOM dynamics in the Med Sea to the change in aerosol deposition pattern due to the effect of climate change

The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

<p>Abstract</p> <p>Background</p> <p>This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects.</p> <p>Methods</p> <p>The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ). One-hundred healthy volunteers were recruited as a control group.</p> <p>Results</p> <p>The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result) and 2.2% in the control group (p < 0.05). An inverse significant nonparametric correlation was found between the NPQ value and the lordosis degree in the AC dislocation group (p = 0.001) wheras results were not correlated (p = 0.27) in the control group.</p> <p>Conclusions</p> <p>Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis.</p

Shoulder adhesive capsulitis in the early freezing phase: correlations between blood exams and Constant Score.

We analysed the possibility that some blood values could be considered as a prognostic index of shoulder adhesive capsulitis. Fifty-six conservatively treated patients were clinically evaluated and prospectively followed at the moment of their freezing phase. At the beginning of the disease (time 0) and after 4 months (time 1), we registered some blood parameters values and their Constant Score (CS). Differences emerged for the white blood cell count (P = 0.037) that decreased and for the CS (P < 0.00001) that increased. At time 0, no significant correlation emerged between the studied parameters and the CS. At time 1, significant inverse correlations with the CS were found for glycaemia (P = 0.007), triglycerides (P = 0.05), ESR (P = 0.017) and CRP (P = 0.013). At time 1, patients with a better shoulder function were those with a low value of glycaemia, triglycerides, ESR and CRP

Morphometry of the suprascapular notch: correlation with scapular dimensions and clinical relevance

Background: Better knowledge of the suprascapular notch anatomy may help to prevent and to assess more accurately suprascapular nerve entrapment syndrome. Our purposes were to verify the reliability of the existing data, to assess the differences between the two genders, to verify the correlation between the dimensions of the scapula and the suprascapular notch, and to investigate the relationship between the suprascapular notch and the postero-superior limit of the safe zone for the suprascapular nerve. Methods: We examined 500 dried scapulae, measuring seven distances related to the scapular body and suprascapular notch; they were also catalogued according to gender, age and side. Suprascapular notch was classified in accordance with Rengachary's method. For each class, we also took into consideration the width/depth ratio. Furthermore, Pearson's correlation was calculated. Results: The frequencies were: Type I 12.4%, Type II 19.8%, Type III 22.8%, Type IV 31.1%, Type V 10.2%, Type VI 3.6%. Width and depth did not demonstrate a statistical significant difference when analyzed according to gender and side; however, a significant difference was found between the depth means elaborated according to median age (73 y.o.). Correlation indexes were weak or not statistically significant. The differences among the postero-superior limits of the safe zone in the six types of notches was not statistically significant. Conclusions: Patient's characteristics (gender, age and scapular dimensions) are not related to the characteristics of the suprascapular notch (dimensions and Type); our data suggest that the entrapment syndrome is more likely to be associated with a Type III notch because of its specific features

Ruolo della linfoadenectomia nel trattamento del cancro gastrico: analisi retrospettiva monocentrica su 406 pazienti

Background: Several studies in the literature have investigated the surgical technique for gastric cancer treatment. Particularly the role of an extended lymphadenectomy is still controversial. Our study compared morbidity and mortality among patients that underwent lymphadenectomy D2 and D2 extended (D2+). Patients and Methods: 406 patients underwent surgery for gastric cancer. A total gastrectomy or a gastric resection with lymphadenectomy D2 or D2+ (extended to stations 12a, 12b, 12p) were performed. Results: 250 (62.8%) patients had advanced cancer at the moment of diagnosis (stages I-19.4%, II-17.8%, III-26.8%, IV-36%). 342 patients underwent curative surgery and among those D0/D1, D2, D2+ lymphadenectomies were respectively 3,6%, 37,9% and 58,5%. In D2 and D2+ lymphadenectomy the median survival was 54.2 (OS 47%) and 39.4 months (OS 44%) respectively. The 5-years overall survival by stages after D2 or D2+ was 66.7% and 77.8% in Stage I, 59.6% and 55.6% in S-II, 26.1% and 32.8% in S-III, 13.8% and 29.4% in S-IV (p=0.242). Morbidity and mortality were 16,6% and 7% in D2 group and 10.9% and 7% in D2+ group. Conclusions: Our experience suggests that a D2 lymphadenectomy can be performed with a satisfactory outcome in term of survival and mortality. D2+ lymphadenectomy does not seem to increase mortality and morbidity; however there are no significant differences in term of survival between the two techniques (p = 0,355)

The relationship between acromion thickness and body habitus: practical implications in subacromial decompression procedures.

To define the bone's amount that should be removed during an acromioplasty has always been a challenge. We aimed to verify the correlations between scapular dimensions and acromial thickness, assess the differences between the two genders, investigate the relationship between acromial type and thickness. We examined 500 dried scapulae, measuring the major axis of the scapular body and the acromial thickness; these were also catalogued according to gender. Acromial shape was classified according to Bigliani's method. Frequencies: Type I 38.9 %, Type II 39.4 %, Type III 21.7 %. The mean acromial thickness was 0.85 cm, and it resulted wider in men. There was a direct linear relationship between scapular dimensions and acromial thickness. The range of thickness of Type III acromion was significantly different from the others. We should be aware that gender, scapular dimensions and acromial shape should be evaluated preoperatively since they influence the acromial thickness

The safe zone for avoiding suprascapular nerve injury during shoulder arthroscopy: an anatomical study on 500 dry scapulae

Hypothesis/background: Suprascapular nerve injury may be a complication during shoulder arthroscopy. Our aim was to verify the reliability of the existing data, assess the differences between scapulae in the 2 genders and in the same subject, obtain a safe zone useful to avoid iatrogenic nerve lesions, and analyze the existing correlations between the scapular dimensions and the safe zone. Methods: We examined 500 dried scapulae, measuring 6 distances for each one, referring to the scapular body, glenoid, and the course of the suprascapular nerve, also catalogued according to gender and side. Differences due to gender were assessed comparing mean +/- sd of each distance in males and females; paired t test was used to compare distances deriving from each couple. Successively, we calculated our safe zone and Pearson's correlation. Results: We found nonsignificant differences between the right and left distances deriving from each couple; differences due to gender were stated. We defined 3 kinds of safe zones referring to: 500 scapulae; males (139 scapulae) and females (147 scapulae). The correlation indexes calculated between the axis of the scapular body and glenoid, and the posterosuperior distance (referring to the suprascapular nerve) were 0.624, 0.694, 0.675, 0.638; while those with the posterior distance were 0.230, 0.294, 0.232, 0.284. Discussion/conclusions: Knowledge of the safe zone, for avoiding suprascapular nerve injury, is important; gender and specific scapular dimensions should be evaluated, as they influence the dimensions of the safe zone. The linear predictors should be used to obtain specific values of the posterosuperior limit in each patient. Level of evidence: Anatomic Study, Cadaver Model. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees